Uniform Residential Loan Application - 2009 Page 13
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16Covered Borrower Identification Statement
Federal law provides important protections to active duty members of the Armed
Forces and their dependents. To ensure that these protections are provided to
eligible applicants, we require you to sign one of the following statements as
applicable:
□
I AM a regular or reserve member of the Army, Navy, Marine
Corps, Air Force, or Coast Guard, serving on active duty under a
call or order that does not specify a period of 30 days or fewer.
□
I AM a dependent of a member of the Armed Forces on active
duty as described above, because I am the member’s spouse, the
member’s child under the age of eighteen years old, or I am an
individual for whom the member provided more than one-half of
my financial support for 180 days immediately preceding today’s
date.
—OR—
□
I AM NOT a regular or reserve member of the Army, Navy,
Marine Corps, Air Force, or Coast Guard, serving on active duty
under a call or order that does not specify a period of 30 days or
fewer (or a dependent of such a member).
Warning: It is important to fill out this form accurately. Knowingly making a
false statement on a credit application is a crime.
Borrower(s) Name
Borrower Signature
Date
Borrower Signature
Date
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